Individual
JASON LAWRENCE PATTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1930 SCENIC HWY N, SNELLVILLE, GA 30078-2150
(770) 972-4709
(770) 972-8367
Mailing address
1930 SCENIC HWY N, SNELLVILLE, GA 30078-2150
(770) 972-4709
(770) 972-8367
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH020529
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH020529
STATE LICENSE NUMBER
GA
Enumeration date
09/20/2011
Last updated
09/20/2011
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